Individual
MARTHA SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1203 CLEVELAND AVE, SUITE 1 A, EAST POINT, GA 30344-3417
(678) 361-7427
Mailing address
1203 CLEVELAND AVE, SUITE 1 A, EAST POINT, GA 30344-3417
(678) 361-7427
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
03/28/2013
Last updated
03/28/2013
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